Method and apparatus for electrosurgically obtaining access to the biliary tree and placing a stent therein

Claim 1

A method of electrosurgically obtaining access to a duct of a patient using a catheter having at least a first lumen and a second lumen defined therethrough, each lumen terminating in an opening defined at a distal end of said catheter, said first lumen of said catheter having an elongated sheath threaded therethrough, said sheath having a needle-knife disposed therein, said needle-knife being connected to a deployment means at a proximal end of said sheath for extending and retracting said needle-knife between a deployed position and a sheathed position relative to a distal end of said sheath, said needle-knife electrically communicating with a power source, said method comprising: inserting said catheter containing said needle-knife and said sheath through an endoscope and into a position proximal to an entrance to a duct of the patient; deploying said needle-knife from said sheathed position relative to said distal end of said sheath; manipulating said needle-knife and applying current thereto to incise tissue proximal to said entrance to said duct; withdrawing said needle-knife into said sheathed position relative to said distal end of said sheath while said sheath remains in said first lumen of said catheter; advancing said catheter into said duct to a desired location within said duct while said sheath remains in said first lumen of said catheter; and infusing a contrast medium through said second lumen of said catheter to visualize said duct while said sheath and said needle-knife remain in said first lumen of said catheter.

Claim 2

A method of electrosurgically obtaining access to a duct of a patient using a catheter having at least a first lumen and a second lumen defined therethrough, each lumen terminating in an opening defined at a distal end of said catheter, said first lumen of said catheter having an elongated sheath threaded therethrough, said sheath having a needle-knife disposed therein, said needle-knife being connected to a deployment means at a proximal end of said sheath for extending and retracting said needle-knife between a deployed position and a sheathed position relative to a distal end of said sheath, said needle-knife electrically communicating with a power source, said method comprising: inserting said catheter containing said needle-knife and said sheath through an endoscope and into a position proximal to an entrance to a duct of the patient; deploying said needle-knife from said sheathed position relative to said distal end of said sheath; manipulating said needle-knife and applying current thereto to incise tissue proximal to said entrance to said duct; withdrawing said needle-knife into said sheathed position relative to said distal end of said sheath while said sheath remains in said first lumen of said catheter; advancing said catheter into said duct to a desired location within said duct while said sheath remains in said first lumen of said catheter; and infusing a contrast medium through said second lumen of said catheter to visualize said duct while said sheath and said needle-knife remain in said first lumen of said catheter.

Claim 5

A method of electrosurgically obtaining access to the biliary tree of a patient and visualizing a duct thereof using a catheter having at least a first lumen and a second lumen defined therethrough, each lumen terminating in an opening defined at a distal end of said catheter, said first lumen of said catheter having a needle-knife disposed therein, said needle-knife being connected to a deployment means at a proximal end of said catheter for extending and retracting said needle-knife between a deployed position and a sheathed position relative to said distal end of said catheter, said needle-knife electrically communicating with a power source, said method comprising the steps of: inserting said catheter and said needle-knife in said sheathed position through an endoscope and into the duodenum of the patient proximal to the entrance to the common bile duct; deploying said needle-knife from said sheathed position relative to said distal end of said catheter; manipulating said needle-knife and applying current thereto to incise tissue proximal to said entrance to said common bile duct; withdrawing said needle-knife into said sheathed position relative to said distal end of said catheter; advancing said catheter into said common bile duct to a desired location within said duct; and infusing a contrast medium through said second lumen of said catheter to visualize said common bile duct through the use of said contrast medium while said needle-knife remains in said first lumen of said catheter.

Claim 6

A method of electrosurgically obtaining access to the biliary tree of a patient and visualizing a duct thereof using a catheter having at least a first lumen and a second lumen defined therethrough, each lumen terminating in an opening defined at a distal end of said catheter, said first lumen of said catheter having a needle-knife disposed therein, said needle-knife being connected to a deployment means at a proximal end of said catheter for extending and retracting said needle-knife between a deployed position and a sheathed position relative to said distal end of said catheter, said needle-knife electrically communicating with a power source, said method comprising the steps of: inserting said catheter and said needle-knife in said sheathed position through an endoscope and into the duodenum of the patient proximal to the entrance to the common bile duct; deploying said needle-knife from said sheathed position relative to said distal end of said catheter; manipulating said needle-knife and applying current thereto to incise tissue proximal to said entrance to said common bile duct; withdrawing said needle-knife into said sheathed position relative to said distal end of said catheter; advancing said catheter into said common bile duct to a desired location within said duct; and infusing a contrast medium through said second lumen of said catheter to visualize said common bile duct through the use of said contrast medium while said needle-knife remains in said first lumen of said catheter.

Claim 9

A method of electrosurgically obtaining access to a duct of a patient using a catheter having at least a first lumen and a second lumen defined therethrough, each lumen terminating in an opening defined at a distal end of said catheter, said first lumen of said catheter having an elongated sheath threaded therethrough, said sheath having a needle-knife disposed therein, said needle-knife being connected to a deployment means at a proximal end of said sheath for extending and retracting said needle-knife between a deployed position and a sheathed position relative to a distal end of said sheath, said needle-knife electrically communicating with a power source, said method comprising: inserting said catheter containing said needle-knife and said sheath through an endoscope and into a position proximal to an entrance to a duct of the patient; deploying said needle-knife from said sheathed position relative to said distal end of said sheath; manipulating said needle-knife and applying current thereto to incise tissue proximal to said entrance to said duct; withdrawing said sheath and said needle-knife through said first lumen of said catheter and then threading a wire guide through said first lumen of said catheter while said catheter remains in said position proximal to said entrance of said duct; advancing said wire guide through said opening defined in said distal end of said catheter and along said duct; advancing said catheter over said wire guide to a desired location within said duct; and infusing a contrast medium through said second lumen of said catheter to visualize said duct while said wire guide remains in said first lumen of said catheter.

Claim 10

A method of electrosurgically obtaining access to a duct of a patient using a catheter having at least a first lumen and a second lumen defined therethrough, each lumen terminating in an opening defined at a distal end of said catheter, said first lumen of said catheter having an elongated sheath threaded therethrough, said sheath having a needle-knife disposed therein, said needle-knife being connected to a deployment means at a proximal end of said sheath for extending and retracting said needle-knife between a deployed position and a sheathed position relative to a distal end of said sheath, said needle-knife electrically communicating with a power source, said method comprising: inserting said catheter containing said needle-knife and said sheath through an endoscope and into a position proximal to an entrance to a duct of the patient; deploying said needle-knife from said sheathed position relative to said distal end of said sheath; manipulating said needle-knife and applying current thereto to incise tissue proximal to said entrance to said duct; withdrawing said sheath and said needle-knife through said first lumen of said catheter and then threading a wire guide through said first lumen of said catheter while said catheter remains in said position proximal to said entrance of said duct; advancing said wire guide through said opening defined in said distal end of said catheter and along said duct; advancing said catheter over said wire guide to a desired location within said duct; and infusing a contrast medium through said second lumen of said catheter to visualize said duct while said wire guide remains in said first lumen of said catheter.

Claim 11

A method for placing a stent in a duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector at said proximal end thereof and at least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to separate said catheter connector from first said catheter, said method comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a duct of the patient; infusing a contrast medium through a second lumen of said first catheter and into said duct while said wire guide remains in said first lumen of said first catheter such that said duct may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said duct; removing said catheter connector from said wire guide; and threading said stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and said first catheter to advance said stent to a desired location within said duct.

Claim 12

A method for placing a stent in a duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector at said proximal end thereof and at least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to separate said catheter connector from first said catheter, said method comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a duct of the patient; infusing a contrast medium through a second lumen of said first catheter and into said duct while said wire guide remains in said first lumen of said first catheter such that said duct may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said duct; removing said catheter connector from said wire guide; and threading said stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and said first catheter to advance said stent to a desired location within said duct.

Claim 13

A method for placing a biliary stent around a biliary calculus in a biliary duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector attached to said proximal end thereof and a least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to sever said catheter connector from said first catheter, said method comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a biliary duct of the patient containing said biliary calculus; infusing a contrast medium through a second lumen of said first catheter and into said biliary duct proximate to said biliary calculus, such that said biliary calculus may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said biliary duct; removing said catheter connector from said wire guide; and threading said biliary stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and first catheter to place said biliary stent around said visualized biliary calculus.

Claim 14

A method for placing a biliary stent around a biliary calculus in a biliary duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector attached to said proximal end thereof and a least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to sever said catheter connector from said first catheter, said method comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a biliary duct of the patient containing said biliary calculus; infusing a contrast medium through a second lumen of said first catheter and into said biliary duct proximate to said biliary calculus, such that said biliary calculus may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said biliary duct; removing said catheter connector from said wire guide; and threading said biliary stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and first catheter to place said biliary stent around said visualized biliary calculus.

Claim 15

A method for placing a stent around a pancreatic obstruction in a pancreatic duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector attached to said proximal end thereof and a least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to sever said catheter connector from said first catheter, comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a pancreatic duct of the patient containing said pancreatic obstruction; infusing a contrast medium through a second lumen of said first catheter and into said pancreatic duct proximate to said pancreatic obstruction, such that said pancreatic obstruction may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said pancreatic duct; and removing said catheter connector from said wire guide; and threading said stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and said first catheter to place said stent around said visualized pancreatic obstruction.

Claim 16

A method for placing a stent around a pancreatic obstruction in a pancreatic duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector attached to said proximal end thereof and a least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to sever said catheter connector from said first catheter, comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a pancreatic duct of the patient containing said pancreatic obstruction; infusing a contrast medium through a second lumen of said first catheter and into said pancreatic duct proximate to said pancreatic obstruction, such that said pancreatic obstruction may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said pancreatic duct; and removing said catheter connector from said wire guide; and threading said stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and said first catheter to place said stent around said visualized pancreatic obstruction.

Claim 17

A method for placing a stent around a cystic obstruction in a cystic duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector attached to said proximal end thereof and a least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to sever said catheter connector from said first catheter, comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a cystic duct of the patient containing said cystic obstruction; infusing a contrast medium through a second lumen of said first catheter and into said cystic duct proximate to said cystic obstruction, such that said cystic obstruction may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said cystic duct; removing said catheter connector from said wire guide; and threading said stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and said first catheter to place said stent around said visualized cystic obstruction.

Claim 18

A method for placing a stent around a cystic obstruction in a cystic duct of a patient using a first catheter having a proximal end and a distal end, said first catheter having a catheter connector attached to said proximal end thereof and a least a first lumen and a second lumen, said first lumen having a wire guide threaded therethrough; said method further using a second catheter having at least one lumen defined therethrough for enabling said second catheter to be threaded over said first catheter to advance said stent over said first catheter; said method further using a catheter cutting means for cutting said first catheter near said proximal end of said first catheter to sever said catheter connector from said first catheter, comprising the steps of: inserting said first catheter and said wire guide through an endoscope and into a cystic duct of the patient containing said cystic obstruction; infusing a contrast medium through a second lumen of said first catheter and into said cystic duct proximate to said cystic obstruction, such that said cystic obstruction may be visualized through the use of said contrast medium; cutting said first catheter near said proximal end of said first catheter with said catheter cutting means to sever said catheter connector from said first catheter while said first catheter remains in said cystic duct; removing said catheter connector from said wire guide; and threading said stent over said wire guide and said first catheter with said second catheter by threading said second catheter over said wire guide and said first catheter to place said stent around said visualized cystic obstruction.